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How do primary healthcare workers in low-income and middle-income countries obtain information during consultations to aid safe prescribing? A systematic review protocol
  1. Chris Smith1,2,
  2. Michelle Helena van Velthoven3,
  3. Neil Pakenham-Walsh4
  1. 1 Graduate School of Tropical Medicine & Global Health (TMGH), Nagasaki University, Nagasaki, Japan
  2. 2 Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
  3. 3 Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, UK
  4. 4 Healthcare Information For All (HIFA) network, Oxford, UK
  1. Correspondence to Dr Chris Smith; christopher.smith{at}


Introduction There is a wide variety in prescribing by primary healthcare workers in low-income and middle-income countries. While there is much information available, both online and offline, there is variation in quality and relevance to different settings. Acting on incorrect or out-of-date information can lead to inappropriate prescribing and impact on patient safety. The aim of this review is to systematically review the evidence on how primary healthcare workers obtain information during consultations to prescribe safely and appropriately.

Methods and analysis We will identify relevant articles by searching electronic databases: Medline (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials, CABI Global Health (Ovid), WHO global health library, POPLINE, Africa-Wide Information (Ebsco), Library, Information Science & Technology Abstracts (Ebsco), and WHO International Clinical Trials Registry Platform. Also, the Health Information For All network will be consulted and evidence databases (TRIP database, Epistemonikos, PDQ Evidence) will be searched. We will hand-search reference lists, run citation searches of included studies and email authors of identified papers. Observational and intervention studies involving primary healthcare workers in low-income and middle-income countries who prescribe and/or dispense medication will be included. The primary outcome is the proportion of healthcare workers obtaining information relevant to consultations from different sources. Secondary outcomes are the change in healthcare provider and patient knowledge or behaviour, adverse outcomes and use of resources. We will exclude studies focusing on secondary care. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data.

Ethics and dissemination No ethics approval is required. Findings will be disseminated through the Healthcare Information For All network.

PROSPERO registration number CRD42018091088.

  • primary care
  • health information
  • prescribing
  • lmics
  • decision-making

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  • Patient consent for publication Not required.

  • Contributors CS and MHvV jointly wrote the protocol. NP-W provided extensive comments on the protocol.

  • Funding This work was supported by Nagasaki University.

  • Disclaimer The funder did not have input in developing this protocol.

  • Competing interests MHvV is the director of Dutches Consulting Ltd which provides advice to clients in the life sciences.

  • Ethics approval No ethics approval is required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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